Download 2016 Dental Code Set

2016 Dental Code Set
For dates of service from 1/1/16-12/31/16
HCPCS
DESCRIPTIONS
D0120
D0140
D0150
D0160
D0180
D0210
D0220
D0230
D0240
D0250
D0260
D0270
D0272
D0273
D0274
D0277
D0290
D0310
D0330
D0340
D0350
D0470
D0502
D1110
D1206
D1208
D1352
D2140
D2150
D2160
D2161
D2330
D2331
PERIODIC ORAL EVALUATION - ESTABLISHED PATIENT
LIMITED ORAL EVALUATION - PROBLEM FOCUSED
COMPREHENSIVE ORAL EVALUATION - NEW OR ESTABLISHED PATIENT
DETAILED AND EXTENSIVE ORAL EVALUATION - PROBLEM FOCUSED, BY REPORT
COMPREHENSIVE PERIODONTAL EVALUATION - NEW OR ESTABLISHED PATIENT
INTRAORAL - COMPLETE SERIES OF RADIOGRAPHIC IMAGES
INTRAORAL - PERIAPICAL FIRST RADIOGRAPHIC IMAGE
INTRAORAL - PERIAPICAL EACH ADDITIONAL RADIOGRAPHIC IMAGE
INTRAORAL - 0CCLUSAL RADIOGRAPHIC IMAGE
EXTRAORAL - FIRST RADIOGRAPHIC IMAGE
EXTRAORAL - EACH ADDITIONAL RADIOGRAPHIC IMAGE
BITEWING - SINGLE RADIOGRAPHIC IMAGE
BITEWINGS - TWO RADIOGRAPHIC IMAGES
BITEWINGS - THREE RADIOGRAPHIC IMAGES
BITEWINGS - FOUR RADIOGRAPHIC IMAGES
VERTICAL BITEWINGS - 7 TO 8 RADIOGRAPHIC IMAGES
POSTERIOR-ANTERIOR OR LATERAL SKULL AND FACIAL BONE SURVEY RADIOGRAPHIC IMAGE
SIALOGRAPHY
PANORAMIC RADIOGRAPHIC IMAGE
CEPHALOMETRIC RADIOGRAPHIC IMAGE
ORAL/FACIAL PHOTOGRAPHIC IMAGES
DIAGNOSTIC CASTS
OTHER ORAL PATHOLOGY PROCEDURES, BY REPORT
PROPHYLAXIS-ADULT
TOPICAL APPLICATION OF FLUORIDE VARNISH
Topical application of fluoride
Preventive resin restoration in a moderate to high caries risk patient - permane
AMALGAM-ONE SURFACE, PRIMARY OR PERMANENT
AMALGAM-TWO SURFACES, PRIMARY OR PERMANENT
AMALGAM-THREE SURFACES, PRIMARY OR PERMANENT
AMALGAM-FOUR OR MORE SURFACES, PRIMARY OR PERMANENT
RESIN-ONE SURFACE, ANTERIOR
RESIN-TWO SURFACES, ANTERIOR
2016 Dental Code Set
For dates of service from 1/1/16-12/31/16
D2332
D2335
D2390
D2391
D2392
D2393
D2394
D2740
D2751
D2790
D2920
D2931
D2940
D2950
D2954
D3110
D3221
D3310
D3320
D3330
D3331
D3346
D3347
D3348
D4210
D4211
D4240
D4241
D4260
D4261
D4263
D4264
RESIN-THREE SURFACES, ANTERIOR
RESIN-FOUR OR MORE SURFACES OR INVOLVING INCISAL ANGLE (ANTERIOR)
RESIN-BASED COMPOSITE CROWN, ANTERIOR
RESIN-BASED COMPOSITE - ONE SURFACE, POSTERIOR
RESIN-BASED COMPOSITE - TWO SURFACES, POSTERIOR
RESIN-BASED COMPOSITE - THREE SURFACES, POSTERIOR
RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES, POSTERIOR
CROWN-PORCELAIN/CERAMIC SUBSTRATE
CROWN-PROCELAIN FUSED TO PREDOMINANTLY BASE METAL
CROWN-FULL CAST HIGH NOBLE METAL
RECEMENT CROWN
PREFABRICATED STAINLESS STEEL CROWN-PERMANENT TOOTH
PROTECTIVE RESTORATION
CORE BUILD-UP, INCLUDING ANY PINS
PREFABRICATED POST AND CORE IN ADDITION TO CROWN
PULP CAP-DIRECT (EXCLUDING FINAL RESTORATION)
PULPAL DEBRIDEMENT, PRIMARY AND PERMANENT TEETH
ENDODONTIC THERAPY, ANTERIOR TOOTH (EXCLUDING FINAL RESTORATION)
ENDODONTIC THERAPY, BICUSPID TOOTH (EXCLUDING FINAL RESTORATION)
ENDODONTIC THERAPY, MOLAR (EXCLUDING FINAL RESTORATION)
TREATMENT OF ROOT CANAL OBSTRUCTION; NON-SURGICAL ACCESS
RETREATMENT OF PREVIOUS ROOT CANAL THERAPY-ANTERIOR
RETREATMENT OF PREVIOUS ROOT CANAL THERAPY-BICUSPID
RETREATMENT OF PREVIOUS ROOT CANAL THERAPY-MOLAR
GINGIVECTOMY OR GINGIVOPLASTY - FOUR OR MORE CONTIGUOUS TEETH OR TOOTH
BOUNDED S
GINGIVECTOMY OR GINGIVOPLASTY - ONE TO THREE CONTIGUOUS TEETH OR TOOTH
BOUNDED S
GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - FOUR OR MORE CONTIGUOUS
TEETH
GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - ONE TO THREE CONTIGUOUS
TEETH
OSSEOUS SURGERY (INCLUDING FLAP ENTRY AND CLOSURE) - FOUR OR MORE CONTIGUOUS
TEE
OSSEOUS SURGERY (INCLUDING FLAP ENTRY AND CLOSURE) - ONE TO THREE CONTIGUOUS
TEE
BONE REPLACEMENT GRAFT - FIRST SITE IN QUADRANT
BONE REPLACEMENT GRAFT - EACH ADDITIONAL SITE IN QUADRANT
2016 Dental Code Set
For dates of service from 1/1/16-12/31/16
D4266
D4267
D4270
D4273
D4274
D4275
D4276
D4341
D4342
D4355
D4910
D4920
D4999
D5620
D5630
D5640
D7111
D7140
D7210
D7220
D7230
D7240
D7241
D7250
D7260
D7261
D7285
D7286
D7310
D7311
D7320
D7321
GUIDED TISSUE REGENERATION - RESORBABLE BARRIER, PER SITE
GUIDED TISSUE REGENERATION - NONRESORBABLE BARRIER, PER SITE, (INCLUDES
PEDICLE SOFT TISSUE GRAFT PROCEDURE
SUBEPITHELIAL CONNECTIVE TISSUE GRAFT PROCEDURES, PER TOOTH
DISTAL OR PROXIMAL WEDGE PROCEDURE (WHEN NOT PERFORMED IN CONJUCTION WITH
SOFT TISSUE ALLOGRAFT
COMBINED CONNECTIVE TISSUE AND DOUBLE PEDICLE GRAFT, PER TOOTH
PERIODONTAL SCALING AND ROOT PLANING - FOUR OR MORE TEETH PER QUADRANT
PERIODONTAL SCALING AND ROOT PLANING - ONE TO THREE TEETH, PER QUADRANT
FULL MOUTH DEBRIDEMENT TO ENABLE COMPREHENSIVE EVALUATION AND DIAGNOSIS
PERIODONTAL MAINTENANCE
UNSCHEDULED DRESSING CHANGE (BY SOMEONE OTHER THAN TREATING DENTIST)
UNSPECIFIED PERIODONTAL PROCEDURE, BY REPORT
REPAIR CAST FRAMEWORK
REPAIR OR REPLACE BROKEN CLASP
REPLACE BROKEN TEETH-PER TOOTH
EXTRACTION, CORONAL REMNANTS - DECIDUOUS TOOTH
EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS
REMOVAL)
SURGICAL REMOVAL OF ERUPTED TOOTH REQUIRING REMOVAL OF BONE AND/OR
SECTIONING OF
REMOVAL OF IMPACTED TOOTH-SOFT TISSUE
REMOVAL OF IMPACTED TOOTH-PARTIALLY BONY
REMOVAL OF IMPACTED TOOTH-COMPLETELY BONY
REMOVAL OF IMPACTED TOOTH-COMPLETELY BONY, WITH UNUSUAL SURGICAL
COMPLICATIONS
SURGICAL REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE)
ORAL ANTRAL FISTULA CLOSURE
PRIMARY CLOSURE OF A SINUS PERFORATION
BIOPSY OF ORAL TISSUE - HARD (BONE, TOOTH)
BIOPSY OF ORAL TISSUE - SOFT
ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE TEETH OR TOOTH
SPAC
ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE TEETH OR TOOTH
ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE TEETH OR
TOOTH
ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE TEETH OR
TOOTH
2016 Dental Code Set
For dates of service from 1/1/16-12/31/16
D7410
D7411
D7412
D7413
D7414
D7415
D7440
D7441
D7450
D7451
D7460
D7461
D7465
D7471
D7490
D7510
D7511
D7520
D7521
D7530
D7540
D7550
D7560
D7610
D7620
D7630
D7640
D7650
D7660
D7670
D7671
D7680
D7710
D7720
EXCISION OF BENIGN LESION UP TO 1.25 CM
EXCISION OF BENIGN LESION GREATER THAN 1.25 CM
EXCISION OF BENIGN LESION, COMPLICATED
EXCISION OF MALIGNANT LESION UP TO 1.25 CM
EXCISION OF MALIGNANT LESION GREATER THAN 1.25 CM
EXCISION OF MALIGNANT LESION, COMPLICATED
EXCISION OF MALIGNANT TUMOR-LESION DIAMETER UP TO 1.25 CM
EXCISION OF MALIGNANT TUMOR-LESION DIAMETER GREATER THAN 1.25 CM
REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR-LESION DIAMETER UP T0 1.25 CM
REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR-LESION DIAMETER GREATER THAN
1.25 CM
REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR-LESION DIAMETER UP TO 1.25
CM
REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR-LESION DIAMETER GREATER
THAN
DESTRUCTION OF LESION(S) BY PHYSICAL OR CHEMICAL METHODS, BY REPORT
REMOVAL OF LATERAL EXOSTOSIS (MAXILLA OR MANDIBLE)
RADICAL RESECTION OF MAXILLA OR MANDIBLE
INCISION AND DRAINAGE OF ABSCESS-INTRAORAL SOFT TISSUE
INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE - COMPLICATED
INCISION AND DRAINAGE OF ABSCESS-EXTRAORAL SOFT TISSUE
INCISION AND DRAINAGE OF ABSCESS - EXTRAORAL SOFT TISSUE - COMPLICATED
REMOVAL OF FOREIGN BODY FROM MUCOSA, SKIN, OR SUBCUTANEOUS ALVEOLAR TISSUE
REMOVAL OF REACTION-PRODUCING FOREIGN BODIES-MUSCULOSKELETAL SYSTEM
PARTIAL OSTECTOMY/SEQUESTRECTOMY FOR REMOVAL OF NON-VITAL BONE
MAXILLARY SINUSOTOMY FOR REMOVAL OF TOOTH FRAGMENT OR FOREIGN BODY
MAXILLA-OPEN REDUCTION (TEETH IMMOBILIZED IF PRESENT)
MAXILLA-CLOSED REDUCTION (TEETH IMMOBILIZED IF PRESENT)
MANDIBLE-OPEN REDUCTION (TEETH IMMOBILIZED IF PRESENT)
MANDIBLE-CLOSED REDUCTION (TEETH IMMOBILIZED IF PRESENT)
MALAR AND/OR ZYGOMATIC ARCH-OPEN REDUCTION
MALAR AND/OR ZYGOMATIC ARCH-CLOSED REDUCTION
ALVEOLUS - CLOSED REDUCTION, MAY INCLUDE STABILIZATION OF TEETH
ALVEOLUS - OPEN REDUCTION, MAY INCLUDE STABILIZATION OF TEETH
FACIAL BONES-COMPLICATED REDUCTION WITH FIXATION AND MULTIPLE SURGICAL
MAXILLA-OPEN REDUCTION
MAXILLA-CLOSED REDUCTION
2016 Dental Code Set
For dates of service from 1/1/16-12/31/16
D7730
D7740
D7750
D7760
D7770
D7771
D7780
D7810
D7820
D7830
D7840
D7850
D7854
D7856
D7858
D7860
D7865
D7870
D7871
D7872
D7873
D7874
D7875
D7876
D7877
D7910
D7911
D7912
D7940
D7941
D7943
D7944
D7945
D7946
D7947
D7948
MANDIBLE-OPEN REDUCTION
MANDIBLE-CLOSED REDUCTION
MALAR AND/OR ZYGOMATIC ARCH-OPEN REDUCTION
MALAR AND/OR ZYGOMATIC ARCH-CLOSED REDUCTION
ALVEOLUS - OPEN REDUCTION STABILIZATION OF TEETH
ALVEOLUS, CLOSED REDUCTION STABILIZATION OF TEETH
FACIAL BONES-COMPLICATED REDUCTION WITH FIXATION AND MULTIPLE SURGICAL
OPEN REDUCTION OF DISLOCATION
CLOSED REDUCTION OF DISLOCATION
MANIPULATION UNDER ANESTHESIA
CONDYLECTOMY
SURGICAL DISCECTOMY; WITH/WITHOUT IMPLANT
SYNOVECTOMY
MYOTOMY
JOINT RECONSTRUCTION
ARTHROTOMY
ARTHROPLASTY
ARTHROCENTESIS
NON-ARTHROSCOPIC LYSIS AND LAVAGE
ARTHROSCOPY-DIAGNOSIS, WITH OR WITHOUT BIOPSY
ARTHROSCOPY-SURGICAL: LAVAGE AND LYSIS OF ADHESIONS
ARTHROSCOPY-SURGICAL: DISC REPOSITIONING AND STABILIZATION
ARTHROSCOPY-SURGICAL: SYNOVECTOMY
ARTHROSCOPY-SURGICAL: DISCECTOMY
ARTHROSCOPY-SURGICAL: DEBRIDEMENT
SUTURE OF RECENT SMALL WOUNDS UP TO 5 CM
COMPLICATED SUTURE-UP TO 5 CM
COMPLICATED SUTURE-GREATER THAN 5 CM
OSTEOPLASTY-FOR ORTHOGNATHIC DEFORMITIES
OSTEOTOMY - MANDIBULAR RAMI
OSTEOTOMY - MANDIBULAR RAMI WITH BONE GRAFT; INCLUDES OBTAINING THE GRAFT
OSTEOTOMY-SEGMENTED OR SUBAPICAL
OSTEOTOMY-BODY OF MANDIBLE
LEFORT I (MAXILLA-TOTAL)
LEFORT I (MAXILLA-SEGMENTED)
LEFORT II OR LEFORT III (OSTEOPLASTY OF FACIAL BONES FOR MIDFACE HYPOPLASIA OR
2016 Dental Code Set
For dates of service from 1/1/16-12/31/16
D7949
D7950
D7955
D7960
D7963
D7970
D7971
D7972
D7980
D7981
D7982
D7983
D7990
D7991
D9110
D9210
D9230
D9223
D9243
D9248
D9310
D9410
D9420
D9430
D9440
D9610
D9612
D9930
D9940
D9951
LEFORT II OR LEFORT III-WITH BONE GRAFT
OSSEOUS, OSTEOPERIOSTEAL, OR CARTILAGE GRAFT OF THE MANDIBLE OR MAXILLA AUTOGE
REPAIR OF MAXILLOFACIAL SOFT AND/OR HARD TISSUE DEFECT
FRENULECTOMY - ALSO KNOWN AS FRENECTOMY OR FRENOTOMY - SEPARATE PROCEDURE
NOT IN
FRENULOPLASTY
EXCISION OF HYPERPLASTIC TISSUE-PER ARCH
EXCISION OF PERICORONAL GINGIVA
SURGICAL REDUCTION OF FIBROUS TUBEROSITY
SIALOLITHOTOMY
EXCISION OF SALIVARY GLAND, BY REPORT
SIALODOCHOPLASTY
CLOSURE OF SALIVARY FISTULA
EMERGENCY TRACHEOTOMY
CORONOIDECTOMY
PALLIATIVE (EMERGENCY) TREATMENT OF DENTAL PAIN-MINOR PROCEDURES
LOCAL ANESTHESIA N0T IN CONJUNCTION WITH OPERATIVE OR SURGICAL PROCEDURES
INHALATION OF NITROUS OXIDE/ANXIOLYSIS, ANALGESIA
INTRAVENOUS MODERATE (CONSCIOUS) SEDATION/ANALGESIA - EACH 15 MINUTE
INCREMENT
INTRAVENOUS MODERATE (CONSCIOUS) SEDATION/ANALGESIA - EACH 15 MINUTE
INCREMENT
NON-INTRAVENOUS CONSCIOUS SEDATION
CONSULTATION - DIAGNOSTIC SERVICE PROVIDED BY DENTIST OR PHYSICIAN OTHER THAN
RE
HOUSE/EXTENDED CARE FACILITY CALL
HOSPITAL OR AMBULATORY SURGICAL CENTER CALL
OFFICE VISIT FOR OBSERVATION (DURING REGULARLY SCHEDULED HOURS) NO OTHER
OFFICE VISIT-AFTER REGULARLY SCHEDULED HOURS
THERAPEUTIC PARENTERAL DRUG, SINGLE ADMINISTRATION
THERAPEUTIC PARENTERAL DRUGS, TWO OR MORE ADMINISTRATIONS, DIFFERENT
MEDICATIONS
TREATMENT OF COMPLICATIONS (POSTSURGICAL) - UNUSUAL CIRCUMSTANCES, BY REPORT
OCCLUSAL GUARDS, BY REPORT
OCCLUSAL ADJUSTMENT-LIMITED